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目的分析痉挛性斜颈患者(CD)经颅超声(TCS)的影像学特点。方法对确诊的25例旋转型CD患者及25名性别、年龄相匹配的健康志愿者进行TCS检查。根据黑质(SN)回声强度分为Ⅰ~Ⅴ级,≥Ⅲ级则视为异常并测量强回声面积,计算强回声总面积与中脑总面积比值;根据豆状核(LN)回声强度分为Ⅰ~Ⅲ级,≥Ⅱ级则视为异常并测量其面积。结果 CD组LN回声≥Ⅱ级比例(17/25,68.00%)明显高于对照组(2/25,8.00%),差异有统计学意义(P<0.001)。LN强回声面积与患者的年龄、病程之间无相关性(P均>0.05)。CD患者中LN阳性侧与患者头部旋转方向相反的比例为70.60%(12/17),明显高于二者相同的比例(5/17,29.40%)。结论 TCS探及LN异常强回声有助于CD的临床诊断,并且LN异常强回声所在位置与CD患者头部旋转方向存在对侧性趋势。
Objective To analyze the imaging features of transcranial ultrasound (TCS) in spastic torticollis (CD) patients. Methods Twenty-five patients with revolving CD and 25 healthy volunteers of the same age were confirmed by TCS. According to the intensity of SN, the echogenicity was classified as grade Ⅰ ~ Ⅴ, and the grade Ⅲ was regarded as abnormal and the area of strong echo was measured. The ratio of total area of hyperechoic to total brain area was calculated. According to the echo intensity of lentiform nucleus Ⅰ ~ Ⅲ grade, ≥ Ⅱ level is considered as abnormal and measure the area. Results There was significant difference (P <0.001) between the level of LN echo ≥ Ⅱ level in the CD group (17 / 25,68.00%) and the control group (2 / 25,8.00%). There was no correlation between the area of hyperechoic echo and the patient’s age and duration (all P> 0.05). The positive ratio of LN positive side to head rotation in patients with CD was 70.60% (12/17), which was significantly higher than the same ratio (5 / 17,29.40%). Conclusion TCS exploration and LN abnormal hyperecho are helpful for the clinical diagnosis of CD, and there is a contradictory trend between the location of abnormal LN and the head rotation of CD patients.